전반적인 간질 환자에서 토피라메이트와 라모트리진이 뇌 포도당대사에 미치는 영향
The Effect ofTopiramate and Lamotrigine on Cerebral Glucose Metabolism in Idiopathic Generalized Epilepsy Patients
주은연, 태우석, 한선정, 한석근, 이성익, 서대원, 이경한, 홍승봉,
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주은연 ( Joo Eun-Yeon )
성균관대학교 의과대학 삼성서울병원 신경과학교실
태우석 ( Tae Woo-Suk )
성균관대학교 의과대학 삼성서울병원 신경과학교실
한선정 ( Han Sun-Jung )
성균관대학교 의과대학 삼성서울병원 신경과학교실
한석근 ( )
성균관대학교 의과대학 삼성서울병원 대장센터 외과학교실
이성익 ( Lee Sung-Ik )
원광대학교 의과대학 신경과학교실
서대원 ( Seo Dae-Won )
성균관대학교 의과대학 삼성서울병원 신경과
이경한 ( Lee Kyung-Han )
성균관대학교 의과대학 삼성서울병원 핵의학과
홍승봉 ( Hong Seung-Bong )
성균관대학교 의과대학 삼성서울병원 신경과학교실
KMID : 0877220050090020129
Abstract
Background: To investigate the effects of topiramate (TPM) or lamotrigine (LTG) on cerebral glucose metabolism, we performed 18F-fluorodeoxy glucose positron emission tomography (FDG-PET) before and after medication in patients with drug naive idiopathic generalized epilepsy.
Methods: Thiry-three patients with newly diagnosed as idiopathic generalized epilepsy (IGE) or IGE without antiepileptic drugs after diagnosis were included. Pre- and post-antiepileptic drug FDG-PET were performed (before and after TPM or LTG administration) in 33 subjects treated with TPM or LTG who had been seizure free for at least 8 weeks. Sixteen of patients received TPM (M/F=8/8, aged 29.2+/-12.3 years) and 17 LTG (M/F=8/9, 26.8+/-9.3 years). For statistical paramateric (SPM) analysis, all PET images were spatially normalized to the standard PET template and then smoothed using a 12-mm full width at half-maximum Gaussian kernel. The paired t-test was used to compare pre- and post-medication FDG-PET images.
Results: SPM analysis of post- and pre-medication FDG-PETs showed TPM reduced glucose metabolism markedly in the thalamus, corpus callosum, and white matters, whereas LTG decreased glucose metabolism in cortico-striato-entorhinal areas with a false discovery rate corrected p<0.05. No brain region showed post-medication hypermetabolism in either group.
Conclusion: Our study demonstrates that both TPM and LTG affect the cerebral glucose metabolism in drug naive idiopathic generalized epilepsy patients.
키워드
Epilepsy;Topiramate;lamotrigine;Cerebral metabolism;FDG-PET;Statistical parametric mapping
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